CIGNA CONTINUES ILLEGAL CONDUCT

Tuesday, May 1st, 2012

Four years have passed since ABC News first exposed CIGNA’s practice of illegally denying and terminating long term disability (“LTD”) claims on Good Morning America. Nonetheless, rather than acting as a fiduciary in the interests of LTD plan claimants, CIGNA continues to act like a company that decides to terminate benefits, and then tries to create evidence to justify terminating benefits.

I just filed two more actions against CIGNA for terminating LTD claims even though: (a) there had been no change, let alone improvement, in the claimants’ conditions; (b) the treating doctors still concluded the claimants could not resume working; and (c) CIGNA rejected the Social Security Administration (“SSA”) decisions that held the claimants were disabled, yet accepted the SSA decisions to offset the claimants’ LTD benefits. The facts of my case also follow the fact pattern of Croll v. Connecticut General Life Insurance (CIGNA), 2012 WL 1439172 (D.Colo. April 26, 2012), which was decided four days ago.

In Croll, CIGNA terminated the claimant’s LTD benefits after many years based upon surveillance and an IME. The court reversed CIGNA’s decision, and ordered CIGNA to pay the LTD benefits and attorney fees to the claimant. The court ruled that there was no evidence in the record suggesting that the claimant’s condition had improved since CIGNA determined that she was disabled; noted that the treating physicians have continued to express their opinions that the claimant is incapable of performing any work because of her disability; and highlighted that the SSA concluded the claimant was disabled. On the other hand, the court said that surveillance showing the claimant shopping and going to the library was not inconsistent with being disabled, and the IME doctor’s opinion was less reliable than those of the treating doctors, which were formed “from a much deeper base of knowledge of Ms. Croll and the effects of her specific history.”

As noted in the article about the Good Morning America expose, insurance companies know that if they deny and terminate claims that many of the claimants will not pursue their claims. Don’t be one of those claimants.

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